The purpose of denial notices is to notify the claimant that the Appeals
Council (AC) has not found a basis for granting review. The AC will not
use a denial notice to make substantive findings, change the outcome of a
hearing decision, make substitute findings, or in any other way revise an
administrative law judge (ALJ) decision. If the AC needs to amend, modify,
or change the substance in an ALJ decision, it must grant the request for
review.

When recommending that the AC deny review, an analyst will prepare a
denial notice for review by the AC. Based on the facts of the case, the
analyst will select the appropriate denial template in the Document
Generation System (DGS) and take any needed action in regard to additional
documents, translations, or other needed language.

In general terms, the notice informs the claimant that the AC action
document is enclosed and that the AC did not find a basis for review was
present. When the AC denies review of an ALJ's decision, the notice also
informs the claimant that he or she has the right to commence a civil
action.

NOTE:

The analyst must be careful to select the appropriate DGS denial notice
template. The claimant has no right to commence a civil action when the AC
denies review of an ALJ's dismissal order, unless the claimant resides in
the 7th Circuit (Illinois, Indiana, or Wisconsin), which is
subject to
Acquiescence
Ruling (AR) 16-1(7), Boley v. Colvin. For
information about AR 16-1(7), see Hearings, Appeals and Litigation Law
(HALLEX) manual I-3-3-15
A.

Section
205(g)
of the Social Security Act provides that a civil action may be brought
“in the district court of the United States for the judicial
district in which the plaintiff resides, or has his principal place of
business, or, if he does not reside or have his principal place of
business within any such judicial district, in the District Court of the
United States for the District of Columbia.” When a claimant resides
in a foreign country, the AC will notify the claimant that he or she has
the right to commence a civil action in the U.S. District Court for the
District of Columbia, or, if applicable, in the judicial district of the
United States where the claimant has his or her principal place of
business. (See Stored Paragraph 6 in the Denial Notice templates in
DGS).

NOTE:

Addresses in American Samoa, Guam, the Commonwealth of Puerto Rico, the
Northern Mariana Islands, and the Virgin Islands are not foreign addresses
for commencing a civil action. Individuals residing in these places may
file a civil action in the local U.S. district court.

Only one AC member signature is required on a denial action. An
administrative appeals judge (AAJ) or an appeals officer (AO) will review
the analyst's proposed action and either agree or disagree with the
recommendation.

If the AC member agrees with the proposed action, he or she will approve
the recommendation and sign the denial notice. In some cases, the AC
member may return the case to the analyst for further analysis or revision
before deciding whether a denial action is appropriate.

If an AAJ is reviewing the case and disagrees with the analyst's
recommendation, he or she will return the case to the analyst with
appropriate instructions for revising the action. However, if an AO is
reviewing the case and disagrees with the analyst's recommendation, the AO
will first discuss the case with his or her supervising AAJ to determine
the next appropriate course of action.